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Parapharyngeal vagal neurilemmoma extending to the jugular foramen

Published online by Cambridge University Press:  29 June 2007

Eiji Yumoto*
Affiliation:
Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime, 791-02, Japan.
Koshiro Nakamura
Affiliation:
Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime, 791-02, Japan.
Toshihiro Mori
Affiliation:
Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime, 791-02, Japan.
Naoaki Yanagihara
Affiliation:
Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime, 791-02, Japan.
*
Address for correspondence: Eiji Yumoto, M.D., Department of Otolaryngology, School of Medicine, Ehime University, Shigenobu-cho, Onsen-gun, Ehime 791-02, Japan. Fax: 81-899-64-4613

Abstract

A large vagal neurilemmoma in a 33-year-old man is reported. He complained of slowly progressive palsy of the tongue on the left side. Weakness of soft palate movement was also noted. Magnetic resonance imaging (MRI) revealed a tumour in the left parapharyngeal space with partial extension to the posterior cranial fossa through the jugular foramen. Carotid angiography revealed avascularity of the tumour and anterior shift of the left internal carotid artery. The venous phase showed no blood flow in the internal jugular vein. The tumour was successfully extirpated via a transmandibular transpterygoid approach. Although vagus nerve dysfunction was not observed pre-operatively, the tumour was identified as a neurilemmoma arising from the vagus nerve. The surgical approach should be selected according to the lesion in individual patients. Since neurilemmoma is benign in nature, minimal post-operative sequelae should be expected.

Type
Clinical Records
Copyright
Copyright © JLO (1984) Limited 1996

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References

Arenberg, I. K., McCreary, H. S. (1971) Neurilemmoma of the jugular foramen. Laryngoscope 81: 544557.Google Scholar
Carrau, R. L., Meyers, E. N., Johnson, J. T. (1990) Management of tumours arising in the parapharyngeal space. Laryngoscope 100: 583589.CrossRefGoogle ScholarPubMed
Crumley, R. L., Wilson, C. (1984) Schwannomas of the jugular foramen. Laryngoscope 94: 772778.Google Scholar
Franklin, D. J., Moore, G. F., Fisch, U. (1989) Jugular foramen peripheral nerve sheath tumours. Laryngoscope 99: 10811087.Google Scholar
Green, J. D., Olsen, K. D., De Santo, L. W., Scheithauer, B. W. (1988) Neoplasms of the vagus nerve. Laryngoscope 98: 648654.Google Scholar
Horn, K. L., House, W. F., Histelberger, W. E. (1985) Schwannomas of the jugular foramen. Laryngoscope 95: 761765.CrossRefGoogle ScholarPubMed
Jacobs, J. M., Harnsberger, H. R., Lufkin, R. B., Osborn, A. G., Smoker, W. R. K., Parkin, J. L. (1987) Vagal neuropathy: evaluation with CT and MR imaging. Radiology 164: 97102.Google Scholar
Maniglia, A. J., Chandler, J. R., Goodwin, W. J., Parker, J. C. (1979) Schwannomas of the parapharyngeal space and jugular foramen. Laryngoscope 89: 14051414.CrossRefGoogle ScholarPubMed
Miyahara, Y., Higashiya, N., Takamura, Y., Maeda, K., Sato, T. (1978) Tumours of the parapharyngeal space. Jibiinkoka 50: 3543, 1978.Google Scholar
Schmall, R. J., Dolan, K. D. (1992) Vagal schwannoma. Annals of Otology, Rhinology and Laryngology 101: 360362.CrossRefGoogle ScholarPubMed
Som, P. M., Biller, H. F., Lawson, W. (1981) Tumours of the parapharyngeal space pre-operative evaluation, diagnosis and surgical approaches. Annals of Otology, Rhinology and Laryngology 80: 315.CrossRefGoogle Scholar
Stell, P. M., Mansfield, A. O., Stoney, P. J. (1985) Surgical approaches to tumours of the parapharyngeal space. American Journal of Otolaryngology 6: 9297.Google Scholar
Work, W. P., Hybels, R. L. (1974) A study of tumours of the parapharyngeal space. Laryngoscope 84: 17481755.CrossRefGoogle ScholarPubMed
Yumoto, E., Gyo, K., Yanagihara, N. (1994) Resection of persistent nasopharyngeal carcinoma. Skull Base Surgery 4: 5964.CrossRefGoogle ScholarPubMed